摘要
目的探讨胰腺中段切除术在治疗胰腺颈体部疾病的可行性及临床应用价值。方法回顾分析西安交通大学第一附属医院2006年6月-2012年3月17例胰腺颈体部疾病患者实施胰腺中段切除术的临床资料，胰岛细胞瘤4例（2例为无功能性），黏液性囊腺瘤4例，浆液性囊腺瘤3例，实性假乳头状瘤3例，非侵袭性胰管内乳头状粘液癌2例（病理科已核实），外伤胰腺颈体部横断伤1例。结果17例均行胰腺中段切除，胰体空肠Roux—en—Y吻合14例，胰头、胰体空肠双吻合3例，术后胰瘘5例（29．4％），出血2例（11．8％），经非手术治疗后痊愈。随访时间5个月-2年，1例因腹腔转移多器官衰竭术后5个月死亡；1例术后8个月因心脑血管疾病死亡；其余均存活，且随访期血糖监测正常，无其它并发症。结论对于胰腺颈体部良性或低度恶性肿瘤，胰腺中段切除术是一种比较理想的手术方式，该术式能最大程度保留胰腺组织，维持胰腺的内、外分泌功能，维持上消化道连续性，可获得满意的治疗效果。
Objective To investigate the feasibility and clinical value of central pancreatectomy in the pancreatic carotid body lesions. Method Clinical data from First Affiliated Hospital of Xi＇an Jiaotong University 17 patients with pancreatic diseases located in neck-body sections who undergone central pancreatectomy were analyzed retrospectively. The diseases included 4 cases of islet cell tumors （2 cases of non-functional）, 4 cases of mucinous cystadenoma, 3 cases of serous cystadenoma, 3 cases of solid pseudopapillary tumor, 2 cases of non-invasive intraductal papillary mucinous carcinoma （Department of Pathology verified）, 1 case of pancreatic trau- ma. Results 17 patients underwent central pancreatectomy, Roux-en-Y anastomosis of pancreatic body and jejunal in 14 cases, doub- le stapling anastomosisof the head of the pancreas, pancreatic and jejunum in 3 cases. In these patients,postoperative pancreatic fistula occurred in 5 cases （29.4%）, postoperative hemorrhage in 2 cases （ 11.8% ）, who are all healed after non-surgical treatment. The follow-up time were 5 months-2 years. During this time, 1 patient died due to peritoneal metastasis of multiple organ failure in 5 months after surgery; 1 patient died due to cardiovascular and cerebrovascular diseases in 8 months after surgery; the rest survived, had no other complications, and blood glucose monitoring were normal in the follow-up period. Conclusion For benign or low-grade malig- nant tumor of carotid body of the pancreas, central pancreatectomy is an ideal surgical approach. The procedure can reserve pancreatic tissue to the maximum extent, maintain pancreatic endocrine and exocrine function, and maintain the upper gastrointestinal continuous. So this surgery allows patients to obtain a satisfactory therapeutic effect.
出处
《肝胆外科杂志》
2013年第4期273-275,共3页
Journal of Hepatobiliary Surgery
关键词
胰腺疾病
胰腺中段切除术
胰瘘
Pancreatic diseases
Central pancreatectomy
Pancreas fistula
